Wanting pain to go away isn't a crime

My wife has more things wrong with her back than the Trump administration has ethics problems. Her neurologist just shook her head when she spoke of bone spurs, spinal stenosis, scoliosis, herniated disks (yes, plural!), and sciatica. Her primary care physician had a similar response but at least, on request, referred her to a pain clinic for evaluation and treatment.

We're thankful for having access to Medicare, and that system has more than once saved our aging keisters from financial disaster. But even with federal help and gap insurance, our medical expenses last year took more than 30 percent of our pension incomes. And now my wife is faced with another series of chronic conditions that produce copious amounts of pain but might not be fixable.

We arrived at the pain clinic a half hour before her appointed time. It's located along a highway with lots of traffic roaring past. The clinic's parking lot was full, with people double parked in the handicapped zone. I dropped my wife off along with her walker and circled the block, finally finding a vacant space. I had no idea that pain is so prevalent.

The clinic's building is a two-story affair with offices and patient treatment on the second floor (Geez, that's logical. Not!). The cramped elevator might hold two people in wheel chairs or with walkers. It's in constant use since most people in pain can't climb stairs. Coming out of the elevator I was shocked to find patients standing and sitting along the breezeway that led to the clinic offices. Inside the cramped waiting room, patients filled the few chairs, many with heads bent, scratching on the 13 pages of paperwork that first-timers must fill out. Try doing that in your lap without a clipboard.

More people piled into the office. I left my wife to her clerical duties and stood outside in the breezeway, on a pop-out balcony exposed to the raucous din of highway traffic and the cold morning wind. More patients exited the elevator. The place reminded me of an old college stunt of seeing how may students could be crammed into a Volkswagen Bug.

As I stood elbow-to-elbow with patients and their spouses, it was easy to tell that most of us were geezers, many with walkers or in wheelchairs, some with canes. They looked resigned to their internal battle with pain. The few younger adults and small children seemed out of place. I was glad for their presence since the kids were the only ones smiling. It's probably too much to expect smiling faces at a pain clinic. But I did feel an overwhelming sense of empathy and kindness from the group as each made room for the new arrivals. I studied the lined and wrinkled masks, the slumped or standing bodies quietly waiting for their name to be called. I could almost feel that craving for sweet relief that allows clenched jaws to relax, for smiles, and maybe even uninterrupted sleep to return.

I stood next to a gray-bearded fellow with an impressive belly covered by a bright print shirt. He recounted how his feet had been mangled while fighting as a Marine in Vietnam. Yet there he stood next to me in the cold wind. He claimed to have so much metal in him that he never could make it through airport security without being thoroughly wanded. A retired college professor with multiple degrees, he taught physics and math at prestigious universities, and loved to ramble on about science.

"After 42 years, I can't stop," he said, grinning.

"Robert" a voice called and off he trundled for a urine test, then a brief visit with a doctor and their physician assistant.

He'd stood there for 30 minutes, teaching me about the physics of the universe, not complaining about pain or his disabilities, a patient patient, and a true Marine.

My father was also a Marine and a stoic. Like the Spartans, I think our culture values stoics, people who internalize their problems and don't bother the rest of us with their issues. But in my father's case, being a stoic probably killed him. One night, he complained about chest pains but wouldn't go to the hospital, claiming it was probably heartburn that would go away. By the next morning, the pain was intolerable, with major parts of his heart muscle destroyed by the attack. If he would have sought treatment immediately ... .

My father's death taught me not to wait. I stared at the pain clinic's patients and wondered how many of them suffered in silence before showing up to crowd into that airy breezeway. Do we look down on people who complain about pain? Do we expect people to just suck it up? And what is the payoff for the persons who maintain their stoicism?

My wife joined me on the breezeway and we waited. A woman leaned toward a man next to her and murmured, "There's only two doctors, you know—and just look at all of us."

By then I had become numb to my surroundings. Finally, they called my wife's name. The doctor was the picture of efficiency. He prescribed injections for some parts of her back pain, new meds for nerve pain, low dosage opioids for when the pain became intolerable, and arranged for a consult with a spinal surgeon to address the most serious stenosis problem. The doctor spoke in direct terms, outlining the consequences of not pursuing treatment—all in a serious, intense, 10-minute consultation while his assistant furiously typed chart notes into their computer system.

Our morning at the pain clinic made me wonder about the federal government's war on opiate abuse and how many of the abusers began by using the drugs for legitimate reasons: to treat pain. It scares me that at some moment, my wife or I might be refused medications over concerns for drug abuse and addiction. I would humbly suggest that the feds focus more on fostering the development of non-addictive pain medications and new treatments, especially those that deal with chronic problems. It should not be a crime to want pain to go away. Δ